Target US Private PT Market11,789 Private Clinics38,800 total US PT clinics • $5.40B Remote + In-Clinic RTM Pool
Clinic Net Profit Per Location+$36K → +$144K / yr50 in-clinic pts (+$36K) to 200 remote+hybrid pts (+$144K net = +160% EBITDA)
KineBuilt™ SaaS ARR / Clinic$30K → $120K / yrFlat $50/monitored pt/mo ($2,500/mo at 50 pts → $10,000/mo at 200 pts)
25-Clinic Founding Group$600K → $3.0M ARR$100K–$125K pre-fund converts 1:1 to credits; owner repaid in Month 1
1. The 4 Parallel Marketing & Distribution Engines
At a glance: We combine automated inbound patient/clinic microsites (Engine 1) and Episteme-verified email deep-links (Engine 2) with Simon Gibson's peer-to-peer multi-clinic owner outreach (Engine 3) and white-label VAR block conversions (Engine 4).
| Marketing Engine | Owner | Target Audience & Database | Mechanism & Live Assets | Conversion & Revenue Output |
|---|---|---|---|---|
| Engine 1: Programmatic PT Microsites & NPI Directory | Mark / Hupp | Post-Op ACL/TKA/Shoulder/Spine/Pelvic Patients + Local PT Clinic Owners | 10 Active 38-Page KineBuilt PT Microsites (380 pages) + 110-Page PT Directory live at kinebuilt-pt-network.pages.dev (scaling to 35 sites / 1,462 pages) |
Every PT clinic can activate KineBuilt RTM ($50/pt/mo) + receive the Verified KineBuilt Badge; 1 clinic/city locks in the $1,500/mo Exclusive City Banner. |
| Engine 2: Episteme-Gated Automated Email-First Outreach | Mark / Brad | 96 Priority NPI PT Clinics (72 FL + 24 Multi-Site Groups) → 11,789 Private PT Clinics | KineBuilt_PT_RTM_Command_Center.html + gtm_kinebuilt_pt_email_engine.py (96/96 verified emails with claim_and_setup.html?npi=... deep-links) |
Owner clicks their ?npi= link, sees their pre-loaded 3-Tier RTM Net Profit (+$36K to +$1.58M/yr), previews their live banner, and signs up in 60 seconds. |
| Engine 3: 500-Evaluation Bottleneck Unlock & 25-Clinic Pre-Fund | Simon Gibson, PT (CEO) | 310 Regional Multi-Clinic Owners (5 to 44 locations each) in multi_clinic_owners_5_to_40.csv |
32-evaluation-bottleneck-unlock.html + 33-single-owner-25-clinics-model.html |
Pre-visit home camera ROM scan cuts PT evals from 50 min to 20 min (2.5x daily eval capacity; recovers $550K per 500 backlogged evals) + converts 10–44 clinic blocks. |
| Engine 4: White-Label VAR & Tebra Marketplace Channel | Simon / Hupp | Regional PT Distributors, Orthopedic Groups & Tebra EHR Clinics | White-label VAR construct ($50 list vs $26–$30 wholesale floor) + Tebra Marketplace at 25 clinics → Tebra Co-Sell at 100 clinics | Scales from 25 founding clinics ($600K ARR) to 120–388 clinics ($3.6M–$34.9M ARR) with near-zero paid CAC. |
2. The 4-Tier Clinic Monetization Menu & 90-Day Execution Schedule
| Clinic Offer Tier | Flat-Fee Pricing (42 U.S.C. § 1320a-7b Safe Harbor) | Eligibility | Clinic Net Return & Deliverables |
|---|---|---|---|
| Tier 1: KineBuilt™ Camera RTM & Pre-Eval Platform | $50 / monitored patient / mo flat (+$500 one-time setup) |
100% of PT Clinics (No 1-per-city cap) |
+$60 to +$85/pt/mo net profit (+$36,000/yr to +$144,000/yr net per location) + Pre-Eval Waitlist Unlocker + KineLedger Billing Exports + Verified KineBuilt™ Directory Badge. |
| Tier 2: KineBuilt™ RTM + #1 Exclusive City Sponsor Banner | $50/pt RTM + $1,500/mo flat ad fee | 1 Clinic Per City | Combines full CMS RTM net profit with the #1 Hero Sponsor Banner across the city directory & 38-page city microsite (+$222,000/yr est. cash/post-op net). |
| Tier 3: Featured PT Directory Clinic Card | $149 / month flat ad fee | Any Licensed PT Clinic | Priority top-tier clinic card + direct evaluation booking button + verified specialty badges. |
| Tier 4: Basic Federal NPI Record Claim / Update | $0 (Free) | All Listed NPI Clinics | Address/phone correction or opt-out (`rating=0, reviews=0` on unclaimed cards per FTC 16 CFR Part 465). |
90-Day Day-by-Day Marketing & Revenue Rollout Schedule
| Window | Action & Campaign | Owner | Target Metric | Proof Artifact |
|---|---|---|---|---|
| Days 1–7 | Deploy 494-page KineBuilt PT Microsite Fleet + Send 25 Verified Clinic Emails/Day from Command Center | Mark / Brad | 96 Priority Clinics Contacted (72 FL + 24 National Groups) | Live HTTP 200 on kinebuilt-pt-network.pages.dev + 96/96 Verified Queue |
| Days 4–14 | FDA Class I 510(k)-Exempt Establishment Registration & Device Listing + Close First 5–25 Founding Clinics | Mark / Simon | FDA FURLS Listing Confirmed + Cohort 1 (5 Clinics / 200 Pts) Enrolled | FDA Listing Screenshot + Signed Founding Credit Agreements ($100K–$125K) |
| Days 15–30 | Onboard Cohorts 2 & 3 (19 Clinics = 760 Active Pts) + Expand Microsites from 10 to 35 Sites | Simon / Brad / Mark | First 98975 Setup & 98985 (2-Day) Claims Submitted; Invoice #1 Paid |
First Monthly KineLedger Report Accepted by Clinic Biller |
| Days 31–60 | Complete 25-Clinic Rollout (1,000 Monitored Pts) + Launch 500-Eval Waitlist Campaign to 310 Multi-Site Owners | Simon / Brad | $50,000/mo KineBuilt MRR ($600K ARR) + $135,000/mo Medicare Billed by Group | Scenario A Operating Breakeven Surpassed (+$22,500/mo Net Operating Cash Flow) |
| Days 61–90 | Activate Remote Step-Down & Statewide Virtual PT Cohort (50 → 150 Pts/Clinic) + Tebra Marketplace Launch | Simon / Hupp / Mark | Scale Toward 75–100 Clinics + 12 Exclusive City Sponsors ($18K/mo Ad Rail) | $1.8M–$3.6M+ ARR Run-Rate Established |
1. KineBuilt™ App Product Requirements Document (PRD v2.0)
At a glance: KineBuilt is a browser-based (PWA) on-device computer-vision movement measurement, pre-evaluation ROM dossier, and CMS RTM billing-evidence platform. Video never leaves the patient's device (P0 law). One loop: Pre-Evaluate at Home (0 min PT time) → Measure & Keep Safe Between Visits (Voice Coach + Form Guard) → Bill CMS RTM (KineLedger).
| Layer | Component | Technical & Clinical Specification | Status / Gate |
|---|---|---|---|
| Layer 1 (L1) | On-Device Pose & ROM Engine | 33-keypoint MediaPipe/BlazePose kinematic angle tracker running in mobile Safari/Chrome (`>=15 fps` on iPhone 11+). Extracts knee flexion/extension, hip angle, shoulder elevation, rep tempo, L/R symmetry, and valgus drift. Zero video frames ever upload. Target reliability: ICC >= 0.85 vs clinical goniometer. |
P0 • Parity Built |
| Layer 2 (L2) | Pre-Eval Dossier & Form Guard Safety Machine | (a) Pre-Visit Home ROM Scan: 3-minute guided home scan + intake outputs a 1-page baseline ROM chart before Visit 1, cutting PT evals from 50 min to 20 min. (b) Form Guard: Per-rep OK → WATCH → FALTERING monitor; halts set if valgus drift exceeds baseline + 2σ for >=2 reps. |
P0 • Core Wedge |
| Layer 3 (L3) | Voice-First Coach & Avatar | Inspectable prompt/script (`/coach/prompt`) with 4-step escalation (`Counting → Pressing → Easing Off → Stopping Set on Rep 7 Drift [124°]`). Deterministic scripted fallback guarantees 100% uptime even offline. | P0 • Demo Verified |
| Layer 4 (L4) | Episteme™ Cite-or-Refuse Gate & KineLedger™ | Every progress summary and every monthly CMS RTM code (`98975`, `98985`/`98977`, `98979`/`98980`+`98981`) carries a deterministic evidence chain (`session_id → metrics → code`) or is marked HELD with the missing threshold named. Part C unfiled IP never ships. |
P0 • Moat Layer |
| Layer 5 (L5) | Splice-Level Consent & Trajectory Registry | Patient-owned longitudinal trajectory passport + splice-level opt-in consent (body region, metric type, time window) for de-identified population benchmarks and IRB research cooperatives. | P1 • Data Asset |
2. Complete Functional Requirements Table (`FR-01` to `FR-12`)
| Req ID | Module | Pri | RFC-2119 Specification & Acceptance Test |
|---|---|---|---|
| FR-01 | On-Device Camera Capture | P0 | MUST measure joint angles (knee, hip, shoulder, ankle), tempo, symmetry, and valgus drift on-device at `>=15 fps`. Network payload MUST contain only numeric JSON vectors over TLS. |
| FR-02 | Pre-Visit Home ROM Dossier | P0 | MUST generate a pre-evaluation baseline ROM & pain dossier from a 3-minute patient home phone scan so the PT completes initial evaluation (`CPT 97161–97163`) in 15–20 minutes instead of 50 minutes. |
| FR-03 | Voice Coach Escalation | P0 | MUST execute the 4-stage voice ladder (`Counting → Pressing → Easing Off → Stop Set`) and pass acceptance vector `[92, 104, 92, 110, 92, 112, 124, 92]` by stopping on Rep 7 (`124° DRIFTING`). |
| FR-04 | Form Guard Intervention Log | P0 | MUST log every `OK → WATCH → FALTERING` transition with timestamp, rep index, and angle delta. False-stop rate target `<10%` of sets. |
| FR-05 | CY2026 Data-Day Ledger | P0 | MUST count qualifying data-days (`>=1 set` with `>=70%` joint visibility) per 30-day window and classify device supply into **`CPT 98985` (2–15 days, ~$51.00)** or **`CPT 98977` (16–30 days, $51.44)** with strict mutual exclusion. |
| FR-06 | Management-Time & Call Tracker | P0 | MUST log PT and PTA (`CQ` modifier) review minutes + verify `>=1 interactive communication` per calendar month, classifying into **`CPT 98979` (10–19m, $26.39)** or **`CPT 98980` (20+m, $54.11)** + **`CPT 98981` (+20m, $41.42; only on 98980)**. |
| FR-07 | KineLedger™ Report Assembler | P0 | MUST output a monthly code-ready billing CSV/PDF per clinic with `GP`/`CQ` modifiers, immutable audit links, and explicit `HELD` status for any code missing a CMS gate. |
| FR-08 | Clinician Console & 7→3 Triage | P0 | MUST render the 6-week ROM trajectory chart, roster data-day bars, and deduped alert feed capped at `<=3 actionable alerts per clinician per day`. |
| FR-09 | Cite-or-Refuse Verdict Panel | P0 | MUST label every clinical summary `SUPPORTED` (with session/metric citations) or `REFUSED` (naming the confounder + what measurement would settle it). |
| FR-10 | Self-Serve Clinic Onboarding | P0 | MUST connect `claim_and_setup.html?npi=...` signups directly to clinic tenant creation and activate the clinic's **Verified KineBuilt™ Provider Badge** on the public directory within 24 hours. |
| FR-11 | Step-Down & Statewide Remote | P1 | MUST support 60–90 day post-discharge remote RTM cohorts and statewide telehealth evaluation intake (`CPT 97161–97163`). |
| FR-12 | Claims-Register CI Gate | P0 | MUST run automated CI regex checks blocking banned diagnostic/predictive phrases (`diagnose`, `predict fall`, `prevent injury`) and forbidden parent-entity strings. |
1. Legal, Regulatory & CMS CPT 98978 Blueprint: The Episteme™ Cognitive Science, Psychology, Neurology & 15-Philosopher Ethics Chatbot
At a glance: YES — building the mental health / human flourishing chatbot on an Episteme™ Closed-World Domain (Cognitive Science + Psychology + Neurology + 15+ Ethical Philosophers) gives you a massive legal and reimbursement advantage over ungrounded LLMs. You can monetize it on TWO legal rails simultaneously: (1) Clinician-Supervised Cognitive Behavioral RTM under CMS CPT 98978 / 98985 + 98980 (~$105–$135/patient/mo Medicare/commercial reimbursement!), and (2) Direct-to-Consumer / Executive Philosophical Ethics & Cognitive Flourishing (100% exempt from FDA device regulation and state psychotherapy licensure).
The Three Legal Tracks (Where We Play vs. What We Never Claim)
| Legal & Commercial Track | Positioning & Intended Use | FDA & State Licensure Status | Monetization & Reimbursement Rail |
|---|---|---|---|
| Track 1: Clinician-Supervised Cognitive Behavioral RTM Adjunct (B2B Clinic Rail) | Enrolled by a licensed Psychologist, LCSW, LMFT, Psychiatrist, or NP/PA for between-visit cognitive restructuring, neurological stress-regulation logging, and structured philosophical reflection. | 100% Legal & CMS-Reimbursable: Licensed clinician owns the diagnosis & Plan of Care. Uses **CMS CPT 98978** (Cognitive Behavioral RTM device supply — the exact mental health twin of PT code 98977!). | CMS pays ~$105–$135/patient/mo (`98975` setup + `98978` 16-day CBT supply or `98985` 2–15 day supply + `98980`/`98981` management). Clinic pays you $45–$50/patient/mo flat fee and nets +$60–$85/pt/mo! |
| Track 2: Direct-to-Consumer Philosophical Ethics, Cognitive Framing & Flourishing Companion (D2C + Microsite Lead Rail) | Framed strictly as **Philosophical Ethics Inquiry, Cognitive Science Literacy, Neuro-Habit Pacing & Personal Flourishing** (zero claims to diagnose or treat clinical DSM-5 psychiatric illness). | 100% Outside FDA Regulation (FDA *General Wellness Policy for Low Risk Devices*) and **100% Exempt from State Therapy Licensure** (including Illinois WOPR Act & Utah HB 452 educational/philosophical carve-outs). | $19–$49/mo D2C Subscription + $1,500/mo Exclusive City Sponsor Banners across your Mental Health / Ketamine / TMS / Psychiatry Microsites (Vertical #7 in your 525-Site Master Plan!). |
| Track 3: Autonomous AI Psychiatric Diagnosis or Unsupervised "AI Therapist" (NEVER DO) | Claiming the chatbot itself is a "licensed therapist" or autonomously diagnoses/treats Major Depressive Disorder, PTSD, or suicidal crisis without a clinician. | Blocked by Law: Triggers FDA Class II `21 CFR § 882.5801` (Prescription Computerized Behavioral Therapy Device requiring 510(k)/RCTs) + violates State Unauthorized Practice of Psychology statutes. | We stay 100% out of Track 3 via our CI Claims Register and Episteme Closed-World Refusal Gate. |
2. The 6 Mandatory Federal & State Legal Gates for a Mental Health / Philosophical Chatbot (2025–2026 Laws)
| Law / Regulation | What the Law Prohibits or Requires | How Our Episteme™ Architecture Complies Deterministically |
|---|---|---|
| 1. State AI Therapy & Disclosure Laws (2025–2026) Illinois WOPR Act (IDFPR AI Therapy Law), Utah HB 452, California AB 3030, Nevada & NY AI Companion Bills |
Prohibits an AI from impersonating a licensed human mental health professional or making independent clinical diagnosis/treatment decisions; mandates clear upfront disclosure that the user is speaking with an AI. Explicitly allows clinician-supervised adjuncts (Track 1) and educational/philosophical self-reflection tools (Track 2). | • Persistent header & session-start disclosure: "Episteme™ Philosophical, Cognitive & Neuro-Educational Companion (AI System — Not a Human Therapist or Medical Diagnosis)." • Zero first-person therapist impersonation strings allowed in CI. |
| 2. Mandatory Crisis & Suicide/Self-Harm Hard Intercept State Duty-to-Warn / Tarasoff Principles & 2025–2026 AI Companion Safety Mandates |
Ungrounded LLMs that continue chatting during a suicidal or self-harm crisis create catastrophic tort liability. | • **Pre-LLM Deterministic Crisis Intercept Gate:** Scans every input for suicide, self-harm, domestic abuse, or violence markers BEFORE calling the LLM (`llm_called = False`). • Immediately halts chat, displays **988 Suicide & Crisis Lifeline** (Call/Text 988), and alerts the supervising clinician in Track 1. |
| 3. CMS Cognitive Behavioral RTM Billing Rules CMS CY2026 Physician Fee Schedule (`CPT 98975, 98978, 98985, 98979, 98980, 98981`) |
Requires a signed Plan of Care from a licensed Psychologist, LCSW, Psychiatrist, NP, or PA; `>=2 days` (98985) or `>=16 days` (98978) of scheduled cognitive/behavioral logging per 30 days; and `>=10 mins` (98979) or `>=20 mins` (98980) of clinician review + 1 interactive check-in. | • Reuses the exact **KineLedger™ Data-Day & Management-Time Assembler** from KineBuilt PT, swapping musculoskeletal code `98977` for Cognitive Behavioral code **`98978`**! |
| 4. FDA 21 CFR § 882.5801 vs. General Wellness Policy FD&C Act § 201(h) & Cures Act § 520(o) |
Software claiming autonomous psychiatric disease treatment requires a Class II 510(k). Software providing structured cognitive/philosophical education, stress management, and clinician-reviewed logging is exempt/low-risk. | • All prompts and outputs are locked to educational cognitive framing, neuroscience literacy, and ethical philosophy—never DSM-5 diagnostic labels or medication advice. |
| 5. FTC Health Breach Notification Rule & Utah HB 452 Ad Ban 16 CFR Part 318 + HIPAA 45 CFR Part 164 |
Strictly bans sharing mental health chat data with third-party ad networks (Meta/Google/TikTok pixels) or selling mental health transcripts for ad targeting. | • Zero third-party advertising pixels on the chatbot surface; BAA isolation for clinic tenants; splice-level user consent. |
| 6. Episteme™ Closed-World Cite-or-Refuse Gate Zero Hallucination & Zero Unverified Psychological Advice |
Prevents the LLM from inventing pop-psychology myths, toxic positivity, or unverified medical claims. | • Every response is synthesized strictly from retrieved records across our 4 verified pillars (Cognitive Science, Psychology, Neurology, and the 15+ Ethical Philosophers) with visible inline citations, or deterministically refuses. |
3. The 4-Pillar Episteme™ Mental Health & Human Flourishing Domain Architecture (Including the 15+ Ethical Philosophers)
| Domain Pillar | Core Theories, Mechanisms & Thinkers Encoded as Verified Episteme Records | How the Patient Uses It in Daily 60-Second Reflections |
|---|---|---|
| Pillar 1: Cognitive Science (`cognitive_science.json`) | • Kahneman & Tversky Dual-Process Theory (System 1 automatic heuristics vs. System 2 deliberate decoupling) • Predictive Processing & Bayesian Belief Updating • Working Memory Cognitive Load Theory & Attentional Control • Metacognitive Calibration & Epistemic Humility |
Helps the user spot when a catastrophic thought is a fast System 1 heuristic rather than a verified fact, and guides a 60-second Bayesian evidence check. |
| Pillar 2: Evidence-Based Psychology | • Aaron Beck & Albert Ellis (Cognitive Restructuring & Socratic Questioning of Automatic Thoughts) • Marsha Linehan (DBT Distress Tolerance, Opposite Action & Radical Acceptance) • Steven Hayes (ACT Cognitive Defusion & Values-Committed Action) • Deci & Ryan (Self-Determination Theory: Autonomy, Competence, Relatedness) • Martin Seligman (Learned Optimism & Explanatory Style) |
Guides structured daily cognitive restructuring and values-aligned behavioral activation logs (counting toward the 16-day `CPT 98978` RTM threshold when enrolled with a clinic). |
| Pillar 3: Behavioral & Affective Neurology | • Prefrontal Cortex (dlPFC/vmPFC) Top-Down Cognitive Reappraisal of Amygdala Threat Salience • HPA-Axis & Vagal Autonomic Pacing (Physiological Sigh / Exhale-Emphasized Downregulation) • Dopaminergic Reward Prediction Error & Small-Win Habit Consolidation (Basal Ganglia Chunking) • Default Mode Network (DMN) Rumination Interruption via Task-Positive Network Engagement |
Explains the exact brain mechanism behind what the user is feeling ("Your amygdala flagged a threat prediction; naming it engages your ventrolateral prefrontal cortex within 60 seconds"). |
| Pillar 4: The 15+ Philosophers of Ethics & Human Flourishing |
1. Aristotle (Nicomachean Ethics — Eudaimonia, Golden Mean & Virtue Habituation) 2. Epictetus (Enchiridion — The Dichotomy of Control) 3. Marcus Aurelius (Meditations — Objective Representation & Inner Citadel) 4. Seneca (Letters from a Stoic — Premeditatio Malorum & Time Stewardship) 5. Socrates / Plato (Apology / Republic — Elenchus, Examined Life & Tripartite Soul Harmony) 6. Baruch Spinoza (Ethics — Transforming Passive Affects/Passions into Active Understanding) 7. Immanuel Kant (Groundwork — Moral Autonomy, Duty & Treating Oneself/Others as Ends, Never Mere Means) 8. John Stuart Mill (Utilitarianism — Higher Faculties, Harm Principle & Long-Horizon Well-Being) 9. Søren Kierkegaard (Either/Or — Authentic Ethical Commitment vs. Aesthetic Drift) 10. Friedrich Nietzsche (The Gay Science — Amor Fati & Self-Overcoming) 11. Viktor Frankl (Man's Search for Meaning — Logotherapy: Meaning via Creation, Experience & Attitude) 12. William James (Principles of Psychology / Pragmatism — Action Precedes Feeling; Habit as Flywheel) 13. John Dewey (Human Nature and Conduct — Reflective Intelligence & Experimental Problem-Solving) 14. Confucius (Analects — Ren, Relational Ethics & Daily Self-Cultivation) 15. Siddhartha Gautama / Early Buddhist Ethics (Dhammapada — Impermanence, Non-Attachment & Right Mindfulness) 16. Martha Nussbaum & Alasdair MacIntyre (Capabilities Approach & Narrative Unity of a Life) |
When a user faces an ethical dilemma, loss, burnout, or conflict, the chatbot presents 2–3 contrasting philosophical lenses (e.g., Epictetus on what is within your control + Viktor Frankl on meaning + Aristotle on the courageous midpoint) with exact citations. |